End effectors for surgical staplers

ABSTRACT

Articulation joints for use in connection with a surgical instrument that has a portion that must be passed through a trocar or similar structure and then articulated relative to another portion of the instrument received within the trocar. Various embodiments of the articulation joint include at least one flexible driven member to articulate the surgical implement relative to the handle assembly of the instrument.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. §120 to U.S. patent application Ser. No. 12/731,347, entitledHYDRAULICALLY AND ELECTRICALLY ACTUATED ARTICULATION JOINTS FOR SURGICALINSTRUMENTS, filed Mar. 25, 2010, now U.S. Patent ApplicationPublication No. 2010/0179382, which is a divisional patent applicationclaiming priority under 35 U.S.C. §121 to U.S. patent application Ser.No. 11/270,866, entitled HYDRAULICALLY AND ELECTRICALLY ACTUATEDARTICULATION JOINTS FOR SURGICAL INSTRUMENTS, filed Nov. 9, 2005, nowabandoned, the entire disclosures of which are hereby incorporated byreference herein.

FIELD OF THE INVENTION

The present invention relates in general to surgical instruments thatare suitable for endoscopically inserting an end effector (e.g.,endocutter, grasper, cutter, staplers clip applier, access device,drug/gene therapy delivery device, an energy device using ultrasound,RF, laser, etc.) and, more particularly, to endocutters witharticulating end effectors.

BACKGROUND OF THE INVENTION

Endoscopic surgical instruments are often preferred over traditionalopen surgical devices since a smaller incision tends to reduce thepost-operative recovery time and complications. Generally, theseendoscopic surgical instruments include an “end effector”, a handleassembly and a long shaft that extends between the end effector and thehandle assembly. The end effector is the portion of the instrumentconfigured to engage the tissue in various ways to achieve a desireddiagnostic or therapeutic effect (e.g., endocutter, grasper, cutter,staplers, clip applier, access device, drug/gene therapy deliverydevice, and energy device using ultrasound, RF, laser, etc.). The endeffector and the shaft portion are sized to be inserted through a trocarplaced into the patient. The elongated shaft portion enables the endeffector to be inserted to a desired depth and also facilitates somerotation of the end effector to position it within the patient. Withjudicious placement of the trocar and use of graspers, for instance,through another trocar, often this amount of positioning is sufficient.Surgical stapling and severing instruments, such as those described inU.S. Pat. No. 5,465,895, are an example of an endoscopic surgicalinstrument that successfully positions an end effector by insertion androtation.

Depending upon the nature of the operation, it may be desirable tofurther adjust the positioning of the end effector of an endoscopicsurgical instrument. In particular, it is often desirable to orient theend effector at an angle relative to the longitudinal axis of the shaftof the instrument. The transverse or non-axial movement of the endeffector relative to the instrument shaft is often conventionallyreferred to as “articulation”. This articulated positioning permits theclinician to more easily engage tissue in some instances, such as behindan organ. In addition, articulated positioning advantageously allows anendoscope to be positioned behind the end effector without being blockedby the instrument shaft.

Approaches to articulating a surgical stapling and severing instrumenttend to be complicated by integrating control of the articulation alongwith the control of closing the end effector to clamp tissue and firethe end effector (i.e., stapling and severing) within the small diameterconstraints of an endoscopic instrument. Generally, the three controlmotions are all transferred through the shaft as longitudinaltranslations. For instance, U.S. Pat. No. 5,673,840 discloses anaccordion-like articulation mechanism (“flex-neck”) that is articulatedby selectively drawing back one of two connecting rods through theimplement shaft, each rod offset respectively on opposite sides of theshaft centerline. The connecting rods ratchet through a series ofdiscrete positions.

Another example of longitudinal control of an articulation mechanism isU.S. Pat. No. 5,865,361 that includes an articulation link offset from acamming pivot such that pushing or pulling longitudinal translation ofthe articulation link effects articulation to a respective side.Similarly, U.S. Pat. No. 5,797,537 discloses a similar rod passingthrough the shaft to effect articulation. Still other examples ofarticulatable surgical stapling devices are disclosed in U.S. Pat. Nos.6,250,532 and 6,644,532.

Due to the types end effector firing systems commonly employed, theactuator arrangements for articulating the end effector must oftengenerate high amounts of torque to bend the firing structure. Thisproblem is exacerbated by the lack of available space for accommodatingactuating devices that are large enough to generate those requiredforces.

Consequently, a significant need exists for an articulating surgicalinstrument that incorporates an articulation mechanism that can generatethe torque necessary to selectively articulate the end effector thereofin a desired manner.

BRIEF SUMMARY OF THE INVENTION

In accordance with another non-limiting embodiment of the presentinvention there is provided a surgical instrument that comprises ahandle assembly and a proximal tube segment that is attached to thehandle assembly. The surgical instrument further comprises a distal tubesegment that is attached to the proximal tube segment by an articulatingjoint assembly. In one non-limiting embodiment, the articulating jointassembly comprises a ball member non-movably coupled to an end of one ofthe proximal and distal tube segments and being rotatably received in acorresponding socket in an end of the other of the proximal tube segmentand distal tube segment. At least one flexible cable is attached to amotor. The flexible cable may have a series of worm gear teeth thereonthat are arranged to drivingly engage a corresponding passageway formedin the ball member or socket for retaining a portion of the ball memberin the socket and, upon selective rotation thereof, articulate thedistal tube segment relative to the proximal tube segment. A surgicalimplement may be attached to the distal tube segment.

In accordance with another embodiment of the present invention there isprovided a surgical instrument that comprises a handle assembly and aproximal tube segment that is attached to the handle assembly. Thesurgical instrument may further comprise a distal tube segment that isattached to the proximal tube segment by an articulating joint assembly.In one non-limiting embodiment, the articulating joint assembly maycomprise a ball member that is non-movably coupled to a distal end ofone of the proximal and distal tube segments. The ball member may berotatably received in a corresponding socket in an end of the other ofthe proximal tube segment and the distal tube segment. At least onerotary driven flexible cable may be arranged to drivingly engage acorresponding portion of the ball member or socket to retain the ballmember in the socket and, upon selective rotation thereof, articulatethe distal tube segment relative to the proximal tube segment. Asurgical implement may be attached to the distal tube segment.

In accordance with another non-limiting embodiment of the presentinvention there is provided a surgical instrument that comprises ahandle assembly and a proximal tube segment that is attached to thehandle assembly. The surgical instrument further comprises a distal tubesegment that is attached to the proximal tube segment by an articulatingjoint assembly. In one non-limiting embodiment, the articulating jointassembly comprises a disc-like member non-movably coupled to an end ofone of the proximal and distal tube segments and being rotatablyreceived in a corresponding socket in an end of the other of theproximal tube segment and distal tube segment. At least one rotarydriven flexible cable may be arranged to drivingly engage acorresponding portion of the disc-like member or socket for retaining aportion of the disc-like member in the socket and, upon selectiverotation, to articulate the distal tube segment relative to the proximaltube segment. A surgical implement may be attached to the distal tubesegment.

One feature of various embodiments of the present invention is toprovide an articulation joint that enables the proximal and distal tubesegments to be coaxially aligned for insertion through a passageway in atrocar and then articulated relative to each other after the joint haspassed through the trocar. Accordingly, various embodiments of theinvention provide solutions to the shortcomings of other articulatedsurgical instruments that are designed to be passed through a trocar orsimilar structure. Those of ordinary skill in the art will readilyappreciate, however, that these and other details, features andadvantages will become further apparent as the following DetailedDescription proceeds.

BRIEF DESCRIPTION OF THE FIGURES

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain various principles of the various embodiments of the presentinvention.

FIG. 1 is a partial perspective view of one non-limiting embodiment of amoment arm extension arrangement employed in connection with ahydraulically operated endocutter with the tube segments thereof in afirst substantially coaxially aligned position;

FIG. 2 is another perspective view of the moment arm extensionarrangement and endocutter of FIG. 1 with the tube segments articulatedat an angle relative to each other;

FIG. 3 is a partial cross-sectional view of an end effector employed inthe endocutter depicted in FIGS. 1 and 2 with the anvil thereof in anopen or unclamped position with some of the elements thereof omitted forclarity;

FIG. 4 is another cross-sectional view of the end effector of FIG. 3 ina closed or clamped position with the cutting bar in an extendedposition;

FIG. 5 is another cross-sectional view of the end effector of FIGS. 3and 4 showing tissue after being cut and stapled therein;

FIG. 6 is an exploded perspective view of the end effector depicted inFIGS. 1-5;

FIG. 7 is another exploded assembly view of the end effector and astaple cartridge;

FIG. 8 is a plan view of a staple cartridge installed in an end effectordepicted in FIGS. 6 and 7;

FIG. 9 is a cross-sectional end view illustrating the end effectorinserted into a trocar passageway;

FIG. 10 is a perspective view of a cartridge installed in an endeffector with the anvil thereof in an open or unclamped position;

FIG. 11 is a schematic depiction of one hydraulic system embodiment ofthe present invention;

FIG. 12 is a partial perspective view of one non-limiting embodiment ofan articulation joint of the present invention in an articulatedposition;

FIG. 13 is another partial perspective view of the articulation jointdepicted in FIG. 12 in an articulated position;

FIG. 14 is another partial perspective view of the articulation jointembodiment depicted in FIGS. 12 and 13 in an articulated position;

FIG. 15 is a partial cross-sectional view of another non-limitingembodiment of an articulation joint of the present invention in anarticulated position;

FIG. 15A is a partial cross-sectional view of another articulation jointof the present invention in an articulated position;

FIG. 16 is a partial cross-sectional view of another articulation jointof the present invention in an articulated position;

FIG. 16A is a partial cross-sectional view of another articulation jointof the present invention in an articulated position;

FIG. 17 is a partial cross-sectional view of another articulation jointembodiment of the present invention in an articulated position; and

FIG. 17A is a partial cross-sectional view another articulation joint ofthe present invention in an articulated position.

DETAILED DESCRIPTION OF THE INVENTION

Turning to the Figures, wherein like numerals denote like componentsthroughout the several views, FIGS. 1 and 2 depict one embodiment of asurgical instrument 10 that is capable of practicing the unique benefitsof the present invention. As can be seen in FIGS. 1 and 2, theinstrument 10 includes a handle assembly 200 and a surgical implementportion 12. As used herein, the term “surgical implement” refers to acomponent or set of components configured to engage tissue to accomplisha surgical task. Examples of surgical implements include, but are notlimited to: endocutters, graspers, clamps, cutters, staplers, clipappliers, probes or access devices, drug/gene therapy delivery devices,energy devices such as ultrasound, RF, or laser devices, etc.

In the non-limiting embodiment depicted in the Figures, the surgicalinstrument 10 includes a hydraulically actuated end effector 22 andhandle arrangement 200 of the type disclosed in the U.S. patentapplication Ser. No. 11/270,217, entitled SURGICAL INSTRUMENT HAVING AHYDRAULICALLY ACTUATED END EFFECTOR, that was filed on Nov. 9, 2005 andwhich is commonly owned with the present application and which thedisclosure thereof is hereby incorporated by reference in its entirety.As the present Detailed Description proceeds, however, the skilledartisan will readily appreciate that the unique and novel features ofthe various embodiments of the present invention may also be employed inconnection with electrically actuated or pneumatically actuated endeffectors. Thus, the various embodiments of the present invention may beadvantageously employed in connection with a variety of surgicalimplements other than the exemplary embodiment depicted in the Figureswithout departing from the spirit and scope of the present invention.Accordingly, the scope of protection afforded to the various embodimentsof the present invention should not be limited to use only with thespecific type of surgical implements specifically described herein.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

FIGS. 3-10 show views of one type of end effector 22 configured toperform clamping, severing and stapling of tissue according to variousembodiments the present invention. In one embodiment, the end effector22 has a body portion 24 that is provided with an elongate channel 26for receiving a staple cartridge 60 therein. An anvil 28 is coupled tothe body portion 24 and is capable of being selectively pivoted towardand away from cartridge 60 mounted in the elongate channel 26. FIGS. 3and 10 illustrate the anvil 28 in an open position and FIGS. 4 and 5illustrate the anvil 28 in a closed position. The anvil 28 may be closedhydraulically and returned to its open position by an energy storingdevice such as a spring 23. As can be seen in FIGS. 3-5, an actuationbladder 40 may be strategically mounted below a portion of the anvil 28such that when the bladder 40 is inflated with a pressurized fluid orair, it biases the anvil 28 to its open position. A supply line 42 iscoupled to the bladder 40 for supplying pressurized fluid from areservoir 232 as will be described in further detail below. Inalternative non-limiting embodiments, an additional hydraulic cylinderor cylinders may be advantageously employed to open and close the anvil.Still in other non-limiting embodiments, the anvil 28 may be opened andclosed by slidable action of a distal tube segment 410 attached thereto.

One type of cartridge that may be used with such end effector is alsodepicted in FIGS. 3-10. The staple cartridge 60 has a cartridge body 62that is divided by an elongated cutting slot 64 that extends from aproximal end 65 of the cartridge 60 toward a tapered outer tip 66. SeeFIG. 10. A plurality of staple-receiving channels 68 are formed withinthe staple cartridge body 64 and are arranged in spaced longitudinalrows 69 on each side of the elongated cutting slot 64. Positioned withinthe staple-receiving channels are staple drivers 70 that each supportone or more staples 72 thereon. The staples 72 are advanced or “fired”by moving their respective drivers 70 in an upward direction toward theanvil 28.

FIG. 10 depicts a three dimensional view of the end effector 22 in anopen position with a staple cartridge 60 installed in the elongatechannel 26. On a lower surface 30 of the anvil 28, a plurality ofstaple-forming pockets 32 are arrayed to correspond to each staplereceiving channel 68 in the cartridge body 62 when the cartridge 60 isinstalled in the end effector 22. More specifically, each forming pocket32 in the anvil 28 may correspond to an individual staple 72 locatedwithin the staple cartridge 60. The staple cartridge 60 may be snap-fitinto the elongate channel 26. For example, extension features 63 of thestaple cartridge 60 engage recesses 27 (shown in FIG. 6) of the elongatechannel 26.

In one embodiment, the staple drivers 70 are driven in an “upward”(toward the anvil 28) direction by a series of hydraulically actuatedbladders 90, 92, 94, 96, 98, 100 situated within the elongated slot 26of the end effector 22 and arranged such that when the bladders 90, 92,94, 96, 98, 100 are inflated, they drive or “fire” the correspondingdrivers 70 and their respective staples 72 toward the anvil 28. As theends of the staple legs contact the corresponding staple forming pockets32 in the anvil 28, they are bent over to close the staple 72. Variousfiring arrangements are disclosed in the abovementioned patentapplication entitled SURGICAL INSTRUMENT HAVING A HYDRAULICALLY ACTUATEDEND EFFECTOR which has been herein incorporated by reference.Pressurized fluid or air is supplied to the bladders 90, 92, 94, 96, 98,100 through a series of supply lines as shown in FIGS. 6 and 11.

Also in one embodiment, to facilitate cutting of tissue 8 clamped in theend effector 22, a hydraulically actuated cutting bar 110 is operativelymounted within the elongated channel 26 and arranged to be receivedwithin the elongated slot 64 in the cartridge body 62 when the cartridge60 is mounted within the end effector 22. The cutting bar 110 extendslongitudinally along the elongate slot 64 and is mechanically coupled toor otherwise supported on a support bar 111 which is attached to ahydraulic cutting bladder 102. By introducing a pressurized fluid or airinto the cutting bladder 102, the cutting bar 110 is forced upward(represented by arrow A in FIG. 4) thereby causing the cutting bar 110to sever the tissue 8 that is clamped between the anvil 28 and thecartridge 60. After the cutting bar 110 has severed the tissue 8, thepressurized fluid is permitted to exit the cutting bladder 102 tothereby permit the bladder 102 to deflate and permit the cutting bar 110to move downward (arrow “B” in FIG. 3) to its retracted or unfiredposition. Pressurized fluid or air is supplied to the cutting bladder102 by supply line 256.

As can be seen in FIGS. 1 and 2, the handle assembly 200 may house ahydraulic system generally designated as 210 for controlling theoperation of the end effector 22. One embodiment of a hydraulic system210 that may be employed to control the end effector 22 is depicted inschematic form in FIG. 11. In this non-limiting embodiment, aconventional hydraulic pump assembly 230 that includes a fluid reservoir232 is employed to supply pressurized fluid to the various bladders. Inone embodiment, the pump 230 is powered by a battery 234 supportedwithin the handle assembly 200. However, the pump 230 could also bepowered by other means, such as by alternating current or by amechanical actuator. The pump 230 may be fluidically coupled to thereservoir 232 by supply line 236 that may have a conventional checkvalve 238 therein. See FIG. 11. As used herein, the term “fluidicallycoupled” means that the elements are coupled together with anappropriate supply, return, discharge, etc. line or other means topermit the passage of pressurized fluid medium, air, etc. therebetween.As used herein, the term “line” as used in “supply line”, “dischargeline” or “return line” refers to an appropriate fluid passage formedfrom conduit, pipe, tubing, etc. for transporting pressurized fluid,air, etc. from one component to another.

In one embodiment, a discharge line 240 attached to the discharge port231 of the pump 230 is piped to a manifold 242 that has designatedsupply lines for each bladder coupled thereto. For example, in theembodiment depicted in FIG. 11, a supply line 244 is coupled to bladder90 and has a control valve 260 therein for controlling the flow ofpressurized fluid through the line 244 to bladder 90. Supply line 246 iscoupled to bladder 92 and has a control valve 262 therein. Supply line248 is coupled to bladder 94 and has a control valve 264 therein. Supplyline 250 is coupled to bladder 96 and has a control valve 266 therein.Supply line 252 is coupled to bladder 98 and has a control valve 268therein. Supply line 254 is coupled to bladder 100 and has a controlvalve 270 therein. Supply line 256 is coupled to cutting bladder 102 andhas control valve 272 therein. Supply line 42 is coupled to the anvilbladder 40 and the supply line 240 by line 241. A supply valve 274 isprovided in line 241 for controlling the flow of pressurized fluidthereto and a return valve 276 is provided to permit the fluid to returnfrom the bladder 40 into the manifold line 242 and through a return line259 that is attached to the manifold 242 and the reservoir 232. As canbe seen in FIG. 11, the return line 259 may have a return valve 278therein. Valves 262, 264, 266, 268, 270, 272, 274, 276, 278 comprise avalve unit, generally designated as 280. In various non-limitingembodiments, the valves 262, 264, 266, 268, 270, 272, 274, 276, 278 mayeach comprise electrically actuated valves, such as, for example, piezovalves or Electro Active Polymer (EAP) valves which may be configured inresponse to an electrical signal. However, other suitable valve andvalve arrangements could be employed.

The above-described valves may be operated by a control circuit 300 inresponse to input received from input buttons, such as buttons 308, 310,312, 314, and/or 316 located on handle. The control circuit may also bepowered by the battery 234 and comprise a suitable circuit capable ofgenerating signals for configuring valve unit 280 in response to inputfrom buttons 308, 310, 312, 314, 316 and/or from other portions of thehandle such as a closure trigger 206 and/or a firing trigger 208 thatare pivotally coupled thereto. In one non-limiting embodiment, thecontrol circuit 300 may include a microprocessor and other relatedcomponents including Random Access Memory (RAM), Read Only Memory (ROM),etc. In other non-limiting embodiments, the control circuit 300 mayinclude various logical circuit elements.

As can be seen in FIGS. 1 and 2, in one non-limiting embodiment, thehandle assembly 200 of the instrument 10 includes a pistol grip 204 thatincludes a closure trigger 206 that is pivotally attached thereto tocommence closure of the anvil 28. In one embodiment, a closure triggersensor 205 is employed to sense when the closure trigger 206 has beenpivoted to the closed position. The closure trigger sensor 205communicates with the control circuit to open the return valve 276 andreturn valve 278 and close supply valve 274 to permit the pressurizedfluid to return from the anvil bladder 28 into the reservoir 232. Theanvil 28 is then pivoted to the closed position by the return spring 23.The closure trigger 206 may be retained in the closed position by arelease button latch arrangement 36 of the type disclosed in U.S. Pat.No. 6,905,057, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING AFIRING MECHANISM HAVING A LINKED RACK TRANSMISSION, the disclosure ofwhich is herein incorporated by reference in its entirety. Anothernon-limiting embodiment links the closure trigger 206 to the tubeassembly 452 and causes it to move distally driving the distal tube 410over the end effector assembly 24 closing the system.

When the end effector 22 is in the closed position, it may be insertedthrough the trocar 490. See FIG. 9. To reopen the end effector 22, therelease button 36 is pressed to unlatch the closure trigger 206 toenable it to pivot away from the firing trigger 208 to an open position.When in the open position, the closure trigger sensor 205 signals thecontrol circuit 300 to power pump 230 and open supply valve 274 andclose return valve 276. Pressurized fluid is then pumped into the anvilbladder 40 to pivot the anvil 28 to the open position. When theclinician has oriented the end effector 22 such that the desired tissueis located between the open anvil 28 and the cartridge 60, the closuretrigger 206 is pivoted to the closed position and latched. Valves 276and 278 are opened and valve 241 is closed. Valves 276 and 278 areopened for a sufficient time to permit the fluid in the anvil bladder 40to be returned therefrom through the lines 42, 242 and 259. Thereafter,those valves are closed. As indicated above, the use of thehydraulically powered bladder and return spring arrangement describedherein is just one type of structure that may be employed to open andclose the anvil 28. Other anvil control arrangements may be employedwithout departing from the spirit and scope of the present inventionand, therefore, the protection afforded to the various embodiments ofthe present invention should not be limited solely to such bladder andreturn spring arrangement.

Input buttons 308, 310, 312, 314, 316 may provide input signals to thecontrol circuit 300 in any suitable way. In one non-limiting embodiment,each input button 308, 310, 312, 314, 316 may correspond to a particularvalve or valves for controlling the inflation of one or more bladders.While five actuation buttons are shown for this non-limiting embodiment,the reader will appreciate that other numbers of buttons may beemployed. For example, if it is desirable to only actuate one staplingbladder at a time, a separate actuation button for each bladder may beprovided. For example, button 308 may control valve 272 in the cuttersupply line 256. By actuating that valve 272, pressurized fluid suppliedby the pump 230 into the manifold 242 is permitted to flow through thesupply line 256 into the cutting bladder 102. Likewise, if actuatorbutton 310 is used to control valves 260, 262, activating the button 310will cause the stapling bladders 90 and 92 to inflate and fire theircorresponding staples 72. Multiple buttons may be selected to createfiring patterns including more than one implement. In other non-limitingembodiments, each input button 308, 310, 312, 314, 316 may represent apre-determined firing order and/or pattern. For example, selecting abutton 308, 310, 312, 314, 316 may cause the control circuit 318 toconfigure the valve unit 304 such that hydraulic devices correspondingto particular surgical implements are fired when the firing trigger 28is depressed. It will be appreciated that various embodiments may havemore or fewer input buttons than are shown. In one embodiment, a firingtrigger 208 is pivotally attached to the handle 200 outboard of theclosure trigger 206 and one or more firing sensors (not shown) may bepositioned to detect the position of the firing trigger. The firingsensors would then communicate with the control circuit 300 to controlthe various valves to permit pressurized fluid to flow to the variousstaple bladders to achieve a desired firing sequence.

In various non-limiting embodiments, the valve unit 280 may beconfigured to introduce a delay to the driving of one or more surgicalimplements included in the end effector 12. For example, it may bedesirable to drive a cutting implement and then delay for apredetermined time before driving one or more zones of a staplingimplement. The delay may be accomplished according to any suitablemethod. In one non-limiting embodiment, the control circuit 300 mayconfigure the valve unit 280 to open a path for hydraulic fluid betweenthe hydraulic pump 230 and a first surgical implement included in theend effector 12. When the firing trigger 28 is actuated, the pump 302may generate pressurized hydraulic fluid, which drives the firstsurgical implement. The control circuit 300 may sense when the firstsurgical implement is driven (e.g., by sensing the position of thefiring trigger 208) and begin a timer that counts off a predetermineddelay time. At the expiration of the predetermined delay time, thecontrol circuit 318 may configure the valve unit 280 to provide thepressurized hydraulic fluid to a second surgical implement. Hydraulicpressure generated at the actuation of the firing trigger 208 may besufficient to drive the second surgical implement, or in variousembodiments, the hydraulic pump 230 may be utilized to generateadditional hydraulic pressure.

In one non-limiting embodiment of the present invention, the endeffector 22 may be attached to the handle assembly 200 by anarticulating joint assembly, generally designated as 400. As can be seenin FIGS. 1, 2, and 12-14, the articulating joint assembly 400 includes adistal tube segment 410 that has a distal end 412, a proximal end 414,and a distal axis H-H. The distal end 412 is mechanically (e.g., rigidlyor slidably connected—depending upon the anvil closure arrangementemployed) coupled to the end effector body 24. The distal tube 410segment may be partially hollow with the proximal end being solid with ahose/wire receiving passage 416 therethrough.

The joint assembly 400 further includes a proximal tube segment 450,that has a proximal end 452, a distal end 454, and a proximal axis I-I.The proximal end 452 is attached to the handle assembly 200. In oneembodiment, for example, the proximal end 452 may be attached to thehandle assembly 200 by an internal channel retainer that is grounded tothe handle assembly. However, other fastening arrangements could beemployed. In one embodiment, the distal end 454 is solid and has ahollow hose/wire-receiving passage 456 therethrough. The remainingportion of the tube segment 450 may be hollow to permit passage of hosesand/or wires therethrough.

In one embodiment, the distal tube segment 410 is pivotally coupled tothe proximal tube segment 450 by a ball joint assembly 460. In oneembodiment, the ball joint assembly 460 comprises a hollow ball member462 that is mounted to or formed on the proximal end 414 of the distaltube segment 410. The ball member 462 is substantially hollow or has ahollow passageway therein to permit the passage of hoses and/or wirestherethrough. The ball member 462 is received in a socket 458 providedin the distal end of the proximal tube segment 450, such that the ballmember 462 is free to pivot therein.

In one embodiment, an actuation assembly, generally designated as 500 isemployed to articulate the distal tube segment 410 relative to theproximal tube segment 450. As can be seen in FIGS. 11-14, in onenon-limiting embodiment, two articulation cylinders 510, 520 areemployed. First articulation cylinder 510 may comprise a conventionalhydraulic or pneumatic cylinder that has a first housing 512 thatcontains a first piston 514 therein. A first piston rod or firstactuation rod 516 is attached to the first piston 514 and protrudes outof the first housing 512. Movement of the piston 514 within the firsthousing 512 in response to the admission of pressurized fluid or air onone side or the other side of the piston 514 causes the first actuationrod 516 to be extended out of the first cylinder housing 512 or into thefirst cylinder housing 512. A distal end 518 of the first housing 512 ispivotally (pinned) or otherwise rigidly attached to the proximal end 414of the distal tube segment 410. The first actuation rod 516 isfabricated from a flexible material such as rubber or the like and thefree end 519 thereof is rigidly affixed to the distal end 454 of theproximal tube segment 450. The free end 519 of the first actuation rod516 may be attached to the distal end 454 by gluing, threads, etc. Afirst indentation 466 or a series of indentations are provided in theouter surface 464 of the ball member to provide the requisite clearancefor the first actuation rod 516 and also the end of the first cylinderhousing 512.

Also in this non-limiting embodiment, the second articulation cylinder520 may comprise a conventional hydraulic or pneumatic cylinder that hasa second housing 522 that contains a second piston 524 therein. A secondpiston rod or second actuation rod 526 is attached to the second piston526 and protrudes out of the second housing 522. Movement of the secondpiston 524 within the second cylinder housing 522 in response to theadmission of pressurized fluid or air on one side or the other side ofthe second piston 524 causes the actuation rod 526 to be extended out ofthe second cylinder housing 522 or into the second cylinder housing 522.The second cylinder housing 522 is pivotally (pinned) or otherwiserigidly attached to the proximal end 414 of the distal tube segment 410.The second actuation rod 526 is fabricated from a flexible material suchas rubber or the like and the free end 529 thereof is rigidly affixed tothe distal end 454 of the proximal tube segment 450. The free end 529 ofthe second actuation rod 526 may be attached to the distal end 454 bygluing, threads, etc. A second indentation 468 or a series ofindentations are provided in the outer surface 464 of the ball member462 to provide the requisite clearance for the second actuation rod 526and also the end of the second cylinder housing 522.

The first and second articulation cylinders 510, 520 may be powered bythe hydraulic system 210 or they may be powered by a separate hydraulicsystem. FIG. 11 depicts one method of controlling the first and secondarticulation cylinders 510, 520. As can be seen in that Figure, a supplyline 570 is connected to the supply line 240 from the pump 230. A firstportion 572 of the supply line 570 is attached to a first supply port inthe first cylinder housing 512 for supplying pressurized fluid or airinto the first cylinder housing 512 on one side of the first piston 514and a second portion 574 of the supply line 570 is attached to a secondsupply port in the first housing 512 for supplying pressurized fluid orair into the first housing 512 on the other side of the first piston514. A first supply valve 576 is mounted in the first portion 572 of thesupply line 570 and a second supply valve 578 is mounted in the secondportion 574 of the first supply line 570. An exhaust or return line 580is provided to return the pressurized fluid from the first housing 512to the fluid reservoir 232. The return line 580 has a first portion 582and a second portion 584 attached to ports in the first housing 512. Afirst return valve 586 is mounted in the first portion 582 of the returnline 580 and a second return valve 588 is mounted in the second portion584 of the return line.

The supply line 570 further has a third portion 590 that is coupled to athird supply port in the second housing 522 on one side of the secondpiston 524 and the supply line 570 has a fourth portion 592 coupled to afourth supply port in the second housing 522 on the other side of thesecond piston 524. A valve 596 is mounted in the third portion 590 andanother valve 598 is mounted in fourth portion 592 of the supply line570. Another return line 600 is provided to permit the pressurizedfluid, air, etc. to return to the reservoir 232 from the housing 522during actuation of the cylinder 520. The return line 600 has a thirdportion 602 attached to a third return port in the second housing 522 onone side of the second piston 524 and a fourth portion 604 of the returnline 600 is coupled to a fourth return port in the second housing 522 onthe other side of the second piston 524. A return valve 606 is providedin the third portion 602 of the return line 600 and another return valve608 is provided in the portion 604 of the return line 600.

The valves may be controlled by the control circuit 300 or a secondcontrol circuit 300′ of the type described above that may include amicroprocessor and other related components including Random AccessMemory (RAM), Read Only Memory (ROM), etc. In other non-limitingembodiments, the control circuit 300′ may include various logicalcircuit elements. A conventional multiposition switch 610 or a series ofswitches, push buttons etc. may be connected to the second controlcircuit 300′ for controlling the valves 576, 578, 586, 588, 594, 596,606, 608 to control the cylinders 510, 520 in the manners necessary toachieve the desired degree and direction of articulation.

When pivotally attached together as described above, the proximal anddistal tube segments 410, 450 form a tube assembly 470 that has apassageway 472 or passageways for supporting the supply lines(collectively designated as 480) between the end effector 22 and thehandle 200. It will be appreciated that the tube assembly 470 has acircumference “C” and shape such that when the distal tube 410 segmentis coaxially aligned with the proximal tube segment 450, the tubeassembly 470 may be inserted through the passageway 492 in a trocar 490.See FIG. 9. In one embodiment, the first and second tube segments 410,450 have a round cross-sectional shape and are sized to be axiallyinserted through a round trocar passageway 492. The outer diameters ofeach the distal tube segments 410, 450 are less than the inner diameterof the trocar passageway 492 to facilitate axial insertion of the tubeassembly 470 through the trocar passage 492 and, if desired ornecessary, rotation of the tube assembly 470 within the trocarpassageway 492. For example, if the trocar passageway 492 has an innerdiameter of approximately 12.8 mm (0.503 inches), the maximum outerdiameter of tube assembly 470 (and of each of the tube segments 410,450) may be approximately 12.7 mm (0.500 inches). It is conceivablethat, for applications wherein the ability to rotate the tube assembly470 within the trocar passageway 492 is not necessary or desirable,trocars with passageways having non-circular cross-sections could beemployed. In those cases, the tube assembly would have a cross-sectionalshape that would facilitate axial insertion of the tube assembly throughthe trocar passageway and may closely resemble the cross-sectional shapeof the trocar passageway. Thus, the various embodiments of the subjectinvention should not be limited to devices having a tube assembly with around cross-sectional shape.

FIG. 1 illustrates the joint assembly in a non-articulated position thatwould enable the tube assembly 470 to be inserted into the trocar. Afterthe surgical implement 12 has be inserted through the trocar 490 and itbecomes desirable to articulate the implement 12, the clinicianactivates the control circuit 300′ through switch 610. Depending uponthe degree and direction of articulation desired, the first piston 516and the second piston 526 may either both be extended, one extended andone retracted or both retracted to cause the ball member 462 to pivot inthe socket to achieve the desired amount of articulation. The pistons516 and 526 are extended by the clinician by activating multipositionswitch or buttons located on the handle assembly to cause the controlcircuit 300′ to open and close the various control valves 576, 578, 586,588, 594, 596, 606, 608. The reader will appreciate that the first andsecond actuation rods 516, 526 may, depending upon the forces, tend tobend rather than pivot during actuation and it is the deflection andbuckling of these rods 516, 526 that further causes the distal tubesegment 410 to articulate relative to the proximal tube segment 450.Moreover, if the articulation cylinders 510,520 are not aligned 180degrees about the longitudinal axis of the device, they can be used toarticulate the end effector in multiple planes as well as merelypivoting it about a point perpendicular to the longitudinal axis. Suchpivotal flexibility is made possible through use of the ball jointarrangement of this embodiment. Such arrangement represents asignificant improvement over other arrangements that can only articulateabout a single axis.

The hydraulic control system described above for actuating thearticulation cylinders 510, 520 is but one example of a control systemthat may be used. The reader will appreciate that a variety of differentcontrol arrangements may be employed to activate the articulationcylinders without departing from the spirit and scope of the presentinvention. For example, the articulation cylinders 510, 520 as describedabove require the admission of pressurized fluid/air to move theirrespective pistons in both directions. Other cylinders that employsprings or other mechanisms for returning the pistons to a startingposition may be employed along with appropriate valve and hydraulicfluid supply arrangement that are within the capabilities of the skilledartisan may be employed. It will be further appreciated that, while twoarticulation cylinders have been described above, other embodiments ofthe present invention may employ only one articulation cylinder or morethan two articulation cylinders. Also, while the ball member 462 hasbeen described as being non-movably mounted to the distal tube segment410 with the socket 458 provided in the proximal tube segment 450, thoseof ordinary skill in the art will understand that the ball member 462may be non-movably attached to the proximal tube segment 450 and thesocket 458 provided in the distal tube segment 410 in other non-limitingembodiments without departing form the sprit and scope of the presentinvention.

FIG. 15 illustrates another articulation joint assembly 1400 embodimentof the present invention. As can be seen in that Figure, distal tubesegment 1410 has a proximal end 1414 and a distal axis H′-H′. Althoughnot shown in FIG. 15, the distal tube segment 1410 has a distal end 1412that is mechanically coupled to the end effector body 24. Depending uponthe anvil closure arrangement employed, the distal end 1412 may benon-movably attached to the end effector body or by a cable, flexiblemember or pivotable member. The distal tube 1410 segment may bepartially hollow with the proximal 1414 end being solid with a hose/wirereceiving passage 1416 therethrough.

The joint assembly 1400 further includes a proximal tube segment 1450,that has a distal end 1454, and a proximal axis I′-I′. Although notshown in FIG. 15, the proximal tube segment 1450 has a proximal end thatis mechanically attached to the handle assembly 200.

In one embodiment, the distal tube segment 1410 is pivotally coupled tothe proximal tube segment 1450 by a ball joint assembly 1460. In oneembodiment, the ball joint assembly comprises a hollow ball member 1462that is mounted to or is formed on the distal end 1454 of the proximaltube segment 1450. The ball member 1462 has a hollow passageway 1464that has a flared or otherwise enlarged end portion 1465 to enable it tocommunicate with the passageway 1416 such that, regardless of theposition of the ball member 1462, the hoses 480 and/or wires extendingtherethrough will not be pinched or otherwise damaged. The ball member1462 is received in a socket 1458 provided in the proximal end 1414 ofthe distal tube segment 1410, such that the ball member 1462 is free topivot or rotate therein.

In one embodiment, an actuation assembly, generally designated as 1500is employed to articulate the distal tube segment 1410 relative to theproximal tube segment 1450. As can be seen in FIG. 15, in onenon-limiting embodiment, two articulation cylinders 1510, 1520 areemployed. First articulation cylinder 1510 may comprise a conventionalhydraulic or pneumatic cylinder that has a first housing 1512 thatcontains a first piston 1514 therein. A first piston rod or firstactuation rod 1516 is attached to the first piston 1514 and protrudesout of the first housing 1512. Movement of the piston 1514 within thefirst housing 1512 in response to the admission of pressurized fluid orair on one side or the other side of the piston 1514 causes the firstactuation rod 1516 to be extended out of the first cylinder housing 1512or into the first cylinder housing 1512. A distal end 1518 of the firsthousing 1512 is pivotally (pinned) to a portion 1415 of the proximal end1414 of the distal tube segment 1410. The outer surface of the proximalend 1414 in the area of the first cylinder housing 1512 may be contouredto facilitate pivotal movement of the cylinder housing 1512. The firstactuation rod 1516 may be fabricated from a flexible material such asrubber or the like or it may be fabricated from rigid material. The freeend 1519 of the actuation rod 516 is pivotally pinned to or otherwiseattached to the distal end 1454 of the proximal tube segment 1450.

Also in this non-limiting embodiment, the second articulation cylinder1520 may comprise a conventional hydraulic or pneumatic cylinder thathas a second housing 1522 that contains a second piston 1524 therein. Asecond piston rod or second actuation rod 1526 is attached to the secondpiston 1524 and protrudes out of the second housing 1522. Movement ofthe second piston 1524 within the second cylinder housing 1522 inresponse to the admission of pressurized fluid or air on one side or theother side of the second piston 1524 causes the actuation rod 1526 to beextended out of the second cylinder housing 1522 or into the secondcylinder housing 1522. The distal end 1523 of the second cylinderhousing 1522 is pivotally (pinned) to a portion 1417 of the proximal end1414 of the distal tube segment 1410. The outer surface of the proximalend 1414 in the area of the second cylinder housing 1522 may becontoured to facilitate pivotal movement of the cylinder housing 1522.The second actuation rod 1526 may be fabricated from a flexible materialsuch as rubber or the like or it may be fabricated from rigid material.The free end 1529 of the actuation rod 1526 is pivotally pinned to orotherwise attached to the distal end 1454 of the proximal tube segment1450.

The first and second articulation cylinders 1510, 1520 may be powered bythe hydraulic system 210 in the same manner as was discussed in detailabove with respect to cylinders 510, 520 or they may be powered by aseparate hydraulic system. FIG. 11 depicts one method of controlling thefirst and second articulation cylinders 1510, 1520. The distal tubesegment 1410 (and the end effector 22 attached thereto) may bearticulated relative to the proximal tube 1450 in the direction shown inFIG. 15 by extending the actuation rod 1526 and retracting the actuationrod 1516. Likewise, the distal tube segment 1410 may be pivoted to adirection opposite to the direction shown in FIG. 15 by extending theactuation rod 1516 and retracting the actuation rod 1526. The controlcircuit 300′ may actuate the cylinders 1510, 1520 in these manners inresponse to the position of the multiposition control switch 610 on thehandle assembly 200. The reader will also appreciate that, while twoarticulation cylinders have been described above, other embodiments ofthe present invention may employ only one articulation cylinder if onlyone degree articulation is needed or desired. Also, while the ballmember 1462 has been described as being non-movably mounted to theproximal tube 1450 with the socket 1458 provided in the distal tubesegment 1410, those of ordinary skill in the art will understand thatthe ball member 1462 may be non-movably attached to the distal tubesegment 1410 and the socket 1458 provided in the proximal tube segment1450 in other non-limiting embodiments without departing from the spiritand scope of the present invention.

In an alternative embodiment depicted in FIG. 15A, the joint assembly1460′ comprises a round disc-like member 1462′ instead of a ball shapedmember. The disc 1462′ has a hollow passageway 1464′ that has a flaredor otherwise enlarged end portion 1465′ to enable it to communicate withthe passageway 1416 such that, regardless of the position of thedisc-like member 1462′, the hoses 480 and/or wires extendingtherethrough will not be pinched or otherwise damaged. The disc-likemember 1462′ is received in a socket 1458′ provided in the proximal end1414 of the distal tube segment 1410, such that the disc-like member1462′ is free to pivot therein. If desired, the outer edge of thedisc-like member 1462′ could be provided with a tongue (not shown) thatis received in a groove (not shown) in the socket wall to furtherstabilize the disc-like member 1462′. This embodiment otherwise employsactuators 1510 and 1520 as described above. Again, however, the readerwill appreciate that, while two articulation cylinders have beendescribed above, other embodiments of the present invention may employonly one articulation cylinder if only one degree articulation is neededor desired. Also, while the disc-like member 1462′ has been described asbeing non-movably mounted to the proximal tube segment 1450 with thesocket 1458′ provided in the distal tube segment 1410, those of ordinaryskill in the art will understand that the disc-like member 1462′ may benon-movably attached to the distal tube segment 1410 and the socket1458′ provided in the proximal tube segment 1450 in other non-limitingembodiments without departing from the spirit and scope of the presentinvention.

Another alternative embodiment is depicted in FIG. 16. As can be seen inthis embodiment, the end 1519 of the first actuation rod 1516 ofcylinder 1510 is attached to portion of the outer surface of the ballmember 1462 and the end 1529 of the second actuation rod 1516 is alsoattached to a portion of the ball member 1462. This embodiment isotherwise identical in composition and operation as the embodimentdepicted in FIG. 15 and described above. Again, however, the reader willappreciate that, while two articulation cylinders have been describedabove, other embodiments of the present invention may employ only onearticulation cylinder if only one degree articulation is needed ordesired. Also, while the ball member 1462 has been described as beingnon-movably mounted to the proximal tube segment 1450 with the socket1458 provided in the distal tube segment 1410, those of ordinary skillin the art will understand that the ball member 1462 may be non-movablyattached to the distal tube segment 1410 and the socket 1458 provided inthe proximal tube segment 1450 in other non-limiting embodiments withoutdeparting from the sprit and scope of the present invention.

Another alternative embodiment is depicted in FIG. 16A. As can be seenin this embodiment, the end 1519 of the first actuation rod 1516 ofcylinder 1510 is attached to portion of the outer surface of thedisc-like member 1462′ and the end 1529 of the second actuation rod 1516is also attached to a portion of the disc-like member 1462′. Thisembodiment is otherwise identical in composition and operation as theembodiment depicted in FIG. 16A and described above. Again, however, thereader will appreciate that, while two articulation cylinders have beendescribed above, other embodiments of the present invention may employonly one articulation cylinder if only one degree articulation is neededor desired. Also, while the disc-like member 1462′ has been described asbeing non-movably mounted to the proximal tube segment 1450 with thesocket 1458′ provided in the distal tube segment 1410, those of ordinaryskill in the art will understand that the disc-like member 1462′ may benon-movably attached to the distal tube segment 1410 and the socket1458′ provided in the proximal tube segment 1450 in other non-limitingembodiments without departing from the spirit and scope of the presentinvention.

FIG. 17 illustrates yet another articulation joint assembly 2400embodiment of the present invention. As can be seen in that Figure,distal tube segment 2410 has a proximal end 2414 and a distal axisH″-H″. Although not shown in FIG. 17, the distal tube segment 2410 has adistal end that is mechanically coupled to the end effector body 24.Depending upon the anvil closure arrangement employed, the distal endmay be non-movably attached to the end effector body or by a cable,flexible member or pivotable member. The distal tube 2410 segment may bepartially hollow with the proximal end 2414 being solid with a hose/wirereceiving passage 2416 therethrough. The passage 2416 may have a conicalshaped portion 2417.

The joint assembly 2400 further includes a proximal tube segment 2450,that has a distal end 2454, and a proximal axis I″-I″. Although notshown in FIG. 18, the proximal tube segment 2450 has a proximal end 2454that is attached to the handle assembly 200.

In one embodiment, the distal tube segment 2410 is pivotally coupled tothe proximal tube segment 2450 by a ball joint assembly 2460. In oneembodiment, the ball joint assembly 2460 comprises a ball member 2462that is mounted to or is formed on the distal end 2454 of the proximaltube segment 2450. The ball member 2462 has a hollow passageway 2464that has a flared or otherwise enlarged end portion 2465 to enable it tocommunicate with the passageway portions 2416, 2417 such that,regardless of the position of the ball member 2462, the hoses 480 and/orwires extending therethrough will not be pinched or otherwise damaged.The ball member 2462 is received in a socket 2458 provided in theproximal end 2414 of the distal tube segment 2410, such that the ballmember 2462 is free to rotate therein.

In one embodiment, an actuation assembly, generally designated as 2500is employed to articulate the distal tube segment 2410 relative to theproximal tube segment 2450. As can be seen in FIG. 17, in onenon-limiting embodiment, two flexible worm gear cables 2510, 2520 areemployed. The first flexible worm gear cable 2510 is adapted todrivingly engage worm gear teeth, threads, etc. (not shown) within afirst gear passage 2465 formed in the ball member 2462. The firstflexible worm gear cable 2510 is coupled to a first motor 2512 that ismounted within the distal tube segment 2410. Similarly, in thisnon-limiting embodiment, a second flexible worm gear cable 2520 isadapted to drivingly engage gear teeth, threads, etc. within a secondgear passage 2467 formed in the ball member 2462 that has worm gearteeth, threads, etc. 2469 formed therein. The second flexible worm gearcable 2520 is coupled to a second motor 2522 mounted in the distal tubesegment 2410. While described herein as “flexible worm gear cables”, itwill be understood that this term is meant to encompass all types offlexible driven cable or driver arrangements that do not necessarilyemploy worm gear-type teeth thereon.

The first and second motors 2512, 2522 may be electrically powered (bybattery 234 or another battery) or be powered by alternating current orbe powered by hydraulic fluid or air. In one embodiment, the motors2512, 2522 are electric powered and are operated by one or more switchesor buttons (not shown) on handle assembly 200. By controlling the amountof rotation and the direction of rotation of the first and second wormgear cables 2510, 2520, the ball member 2462 is cause to rotate withinthe socket 2458 and thereby articulate the distal tube segment 2410 (andthe end effector 22 attached thereto) relative to the proximal tubesegment 2450. The reader will appreciate that such arrangementfacilitates left articulation as shown in FIG. 17 and right articulation(not shown). Again, however, the reader will appreciate that, while twoflexible worm gear cable/motor arrangements have been described above,other embodiments of the present invention may employ only one flexibleworm gear cable arrangement if only one degree articulation is needed ordesired. Also, while the ball member 2462 has been described as beingnon-movably mounted to the proximal tube segment 2450 with the socket2458 provided in the distal tube segment 2410, those of ordinary skillin the art will understand that the ball member 2462 may be non-movablyattached to the distal tube segment 2410 and the socket 2458 provided inthe proximal tube segment 2450 in other non-limiting embodiments withoutdeparting from the spirit and scope of the present invention.

In an alternative embodiment depicted in FIG. 17A, the joint assembly2460′ comprises a round disc-like member 2462′ instead of a ball shapedmember. The disc-like member 2462′ has a hollow passageway 2464′ thathas a flared or otherwise enlarged end portion 2465′ to enable it tocommunicate with the passageway 2416 such that, regardless of theposition of the disc-like member 2462′, the hoses 480 and/or wiresextending therethrough will not be pinched or otherwise damaged. Thedisc-like member 2462′ is received in a socket 2458′ provided in theproximal end 2414 of the distal tube segment 2410, such that thedisc-like member 2462′ is free to rotate therein. If desired, the outeredge of the disc-like member 2462′ could be provided with a tongue (notshown) that is received in a groove (not shown) in the socket wall tofurther stabilize the disc-like member 1462′. This embodiment otherwiseemploys the motor driven flexible worm gear cables 2510 and 2520 asdescribed above. Again, however, the reader will appreciate that, whiletwo flexible worm gear cable/motor arrangements have been describedabove, other embodiments of the present invention may employ only oneflexible worm gear cable arrangement if only one degree articulation isneeded or desired. Also, while the disc-like member 2462′ has beendescribed as being non-movably mounted to the proximal tube segment 2450with the socket 2458′ provided in the distal tube segment 2410, those ofordinary skill in the art will understand that the disc-like member2462′ may be non-movably attached to the distal tube segment 2410 andthe socket 2458′ provided in the proximal tube segment 2450 in othernon-limiting embodiments without departing from the spirit and scope ofthe present invention.

The various non-limiting embodiments of the present invention provide ahost of advantages over prior art articulated surgical instruments. Inparticular, the various embodiments of the subject invention enable theportions of the tube member that attach a surgical implement to a handleto be inserted through a trocar or similar device and then beselectively articulated within the patient. While the variousembodiments have been described herein in connection with use with ahydraulically operated endocutter, those of ordinary skill in the artwould appreciate that the various embodiments of the subject inventioncould be employed with electrically powered endocutters and with a hostof other types of surgical implements, regardless of whether they areelectrically or hydraulically powered.

While the present invention has been illustrated by description ofseveral embodiments and while the illustrative embodiments have beendescribed in considerable detail, it is not the intention of theapplicant to restrict or in any way limit the scope of the appendedclaims to such detail. Additional advantages and modifications mayreadily appear to those skilled in the art. Accordingly, the presentinvention has been discussed in terms of endoscopic procedures andapparatus. However, use herein of terms such as “endoscopic” should notbe construed to limit the present invention to a surgical stapling andsevering instrument for use only in conjunction with an endoscopic tube(i.e., trocar). On the contrary, it is believed that the presentinvention may find use in any procedure where access is limited to asmall incision, including but not limited to laparoscopic procedures, aswell as open procedures. Moreover, the various embodiment of the presentinvention should not be limited solely to use in connection withsurgical instruments that have hydraulically powered or air poweredsurgical implements. The various embodiments of the present inventionmay also be effectively used with surgical instruments and the like thatemploy electrically driven surgical implements.

1-19. (canceled)
 20. A surgical instrument, comprising: a shaft; an endeffector extending from the shaft, wherein the end effector comprises:an anvil including a staple forming portion; a cutting member; and astaple cartridge, comprising: a cartridge body including a proximal endand a distal end; an elongate slot extending between the proximal endand the distal end, wherein the cutting member is movable relative tothe elongate slot to cut tissue captured between the anvil and thestaple cartridge; a deck, comprising: a first deck surface; and a seconddeck surface, wherein one of the first deck surface and the second decksurface is stepped up from the other one of the first deck surface andthe second deck surface; a plurality of first staple cavities arrangedin a first row on a lateral side of the elongate slot, wherein the firstrow extends along the first deck surface; a plurality of second staplecavities arranged in a second row on the lateral side of the elongateslot, wherein the second row is closer to the elongate slot than thefirst row, and wherein the second row extends along the second decksurface; a plurality of first staples removably stored in the pluralityof first staple cavities, wherein the plurality of first staplescomprises a first unformed height; and a plurality of second staplesremovably stored in the plurality of second staple cavities, wherein theplurality of second staples comprises a second unformed height differentfrom the first unformed height; and a control assembly, comprising: acontrol circuit configured to generate a drive signal; and a drive unitmovable in response to the drive signal to deploy the plurality of firststaples and the plurality of second staples.
 21. The surgical instrumentof claim 20, wherein the plurality of first staples comprises: a distalstaple positioned in the first row; a proximal staple positioned in thefirst row, wherein the proximal staple is positioned proximally to thedistal staple along the first row, and wherein the distal staple and theproximal staple are deployed simultaneously into the tissue capturedbetween the anvil and the staple cartridge.
 22. The surgical instrumentof claim 21, wherein the plurality of second staples comprises a secondstaple positioned in the second row, wherein the second staple issimultaneously deployed with the distal staple and the proximal staplein the first row.
 23. The surgical instrument of claim 20, wherein thecontrol assembly comprises an input member actuatable to generate aninput signal.
 24. The surgical instrument of claim 23, wherein thecontrol circuit is configured to generate the drive signal in responseto the input signal.
 25. A surgical instrument, comprising: a fastenercartridge, comprising: a cartridge body including a proximal end and adistal end; an elongate slot extending between the proximal end and thedistal end; a deck, comprising: a first deck surface; and a second decksurface, wherein one of the first deck surface and the second decksurface is positioned higher than the other one of the first decksurface and the second deck surface; a plurality of first fastenercavities arranged in a first row on a lateral side of the elongate slot,wherein the first row extends along the first deck surface; a pluralityof second fastener cavities arranged in a second row on the lateral sideof the elongate slot, wherein the second row is closer to the elongateslot than the first row, and wherein the second row extends along thesecond deck surface; a plurality of first fasteners removably stored inthe plurality of first fastener cavities, wherein the plurality of firstfasteners comprises a first unformed height; and a plurality of secondfasteners removably stored in the plurality of second fastener cavities,wherein the plurality of second fasteners comprises a second unformedheight different from the first unformed height; and a control circuitcomprising a processor configured to generate a drive signal to deploythe plurality of first fasteners and the plurality of second fasteners.26. The surgical instrument of claim 25, wherein the plurality of firstfasteners comprises: a distal fastener positioned in the first row; aproximal fastener positioned in the first row, wherein the proximalfastener is positioned proximally to the distal fastener along the firstrow, and wherein the distal fastener and the proximal fastener aredeployed simultaneously.
 27. The surgical instrument of claim 26,wherein the plurality of second fasteners comprises a second fastenerpositioned in the second row, wherein the second fastener issimultaneously deployed with the distal fastener and the proximalfastener in the first row.
 28. The surgical instrument of claim 25,wherein the control circuit comprises an input member actuatable togenerate an input signal
 29. The surgical instrument of claim 28,wherein the processor is configured to generate the drive signal inresponse to the input signal.
 30. A surgical instrument, comprising: ashaft; an end effector extending from the shaft, wherein the endeffector comprises: an anvil including a staple forming portion; acutting member; and a staple cartridge, comprising: a cartridge bodyincluding a proximal end and a distal end; an elongate slot extendingbetween the proximal end and the distal end, wherein the cutting memberis movable relative to the elongate slot to cut tissue captured betweenthe anvil and the staple cartridge; a deck, comprising: a first decksurface; and a second deck surface, wherein one of the first decksurface and the second deck surface is stepped up from the other one ofthe first deck surface and the second deck surface; a plurality of firststaple cavities arranged in a first row on a lateral side of theelongate slot, wherein the first row extends along the first decksurface; a plurality of second staple cavities arranged in a second rowon the lateral side of the elongate slot, wherein the second row iscloser to the elongate slot than the first row, and wherein the secondrow extends along the second deck surface; a plurality of first staplesremovably stored in the plurality of first staple cavities, wherein theplurality of first staples comprises a first unformed height; and aplurality of second staples removably stored in the plurality of secondstaple cavities, wherein the plurality of second staples comprises asecond unformed height different from the first unformed height; and adrive assembly, comprising: a motor configured to generate at least onerotary motion; and an driven member configured to transmit at least onemotion to the end effector in response to the at least one rotarymotion.
 31. The surgical instrument of claim 30, wherein the pluralityof first fasteners comprises: a distal fastener positioned in the firstrow; a proximal fastener positioned in the first row, wherein theproximal fastener is positioned proximally to the distal fastener alongthe first row, and wherein the distal fastener and the proximal fastenerare deployed simultaneously into tissue captured between the anvil andthe staple cartridge.
 32. The surgical instrument of claim 31, whereinthe plurality of second fasteners comprises a second fastener positionedin the second row, wherein the second fastener is simultaneouslydeployed with the distal fastener and the proximal fastener in the firstrow.
 33. The surgical instrument of claim 30, wherein the driven memberis an articulation member configured to articulate the end effectorrelative to the shaft in response to the at least one rotary motion.